We often talk about the problems religion brings upon women by forbidding the use of birth control, but, oddly enough, there's a phenomenon in the ultra-Orthodox Jewish community which is causing the exact opposite problem. Their strict religious rules, known as halacha, govern many aspects of women's lives, including when they're allowed to have sex with their husbands, and one rule in particular is preventing some women from being able to get pregnant even when they desperately want to.

Known as "halachic infertility," the problem arises because of the rules governing woman's menstrual cycle. The practice stems from the Torah, which says that women cannot have sex with their husbands while they've got their period and must clean themselves in a ritual bath, called a mikveh, before they can be with their husbands again. In the days of the Bible, women went to the mikveh a few days after their period had stopped, but according to Forward, "Rabbis streamlined these regulations in the Talmud, decreeing that all women should wait a full seven days after they stopped bleeding to visit the mikveh." Today Orthodox women usually abstain for five days to accomodate their periods and then wait another seven days before they go to the mikveh. That means there are 12 days out of their cycle during which they can't have sex.

For most women, this isn't a problem because they ovulate around 14 days after the begin menstruating, so sexual activity with their husbands begins again right around the time they're most fertile. That likely explains why most ultra-Orthodox communities have sky high fertility rates. But for the women whose cycles are slightly off from the norm, causing them to ovulate before day 12 of their cycle, this restriction means they can't have sex when they're fertile and makes it very difficult or impossible for them to get pregnant.

Of course, the solution to this problem would be for these women to simply visit the mikveh earlier, but that isn't allowed under the very inflexible interpretation of this rule. Rabbis don't usually allow women to make the adjustments to when they visit the mikveh, and most women say they don't want to break the rule in order to get pregnant. Brany Rosen, who cofounded an infertility support group, says, "I don't want to conceive a baby that way." Dr. Richard Grazi, who's been treating ultra-Orthodox women for 25 years, says he learned there's no point in trying to persuade women to go to the mikveh early. He says, "That is just a nonstarter. I know where my patients and my rabbis are coming from."

So what's the alternative? Strangely enough, it's to use hormonal treatments to change the women's cycle. Grazi usually prescribes an adhesive patch that delivers estradiol, which can delay ovulation until after the woman visits the mikveh. If that doesn't work, he will also prescribe a drug to stimulate egg development. Or there's the more drastic step of using Lupron, a medication which "mutes the body's egg development and ovulation." The woman then takes a series of hormone injections to modify her cycle so that she ovulates when she's able to have sex with her husband. That seems like a lot of work and unnatural intervention to achieve what God supposedly intends—especially since way back in the day, the ritual did not even specify the 12-day waiting period.

There's one final action couples take if the hormones aren't an option: artificial insemination. This allows a woman to get pregnant without technically touching her husband, so she can do it during the period before she visits the mikveh. This is slightly more controversial with Rabbis, however, some of whom believe that conceiving this way "can cause spiritual harm to the child." This method can also cause a problem because men aren't allowed to masturbate, so getting a sperm sample is tricky. Some instead use a "medical grade polyurethane condom" to collect sperm while they're having sex. Of course, since prophylactics aren't technically allowed either, couples will often "poke a small hole in the condom as a symbolic gesture."

To the outsider, using all of these medications to avoid breaking a rule that seems relatively arbitrary in the first place can seem pretty strange. But Chaim Jalas, who directs patient services at an Orthodox fertility center, says, "There are some rules that are extremely strict. The idea here is that the halacha doesn't change." The 12-day abstention ritual is considered "the foundation of family life." So even if it seems that using all of these modern interventions breaks the spirit of the law if not the letter of it, women are made to bend over backwards to get pregnant during the God-sanctioned period rather than risk starting their families off on the wrong spiritual footing.